Provider Demographics
NPI:1548225568
Name:SHAIKH, FARRUKH S (MD)
Entity Type:Individual
Prefix:
First Name:FARRUKH
Middle Name:S
Last Name:SHAIKH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3884
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25338-3884
Mailing Address - Country:US
Mailing Address - Phone:304-345-1156
Mailing Address - Fax:304-345-1158
Practice Address - Street 1:415 MORRIS ST
Practice Address - Street 2:SUITE 209
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1842
Practice Address - Country:US
Practice Address - Phone:304-345-1156
Practice Address - Fax:304-345-1158
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV206452084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1806662001Medicaid
WVP00077037OtherRAILROAD
WV1065181OtherWORKERS COMPENSATION
WVSH4071962Medicare PIN
WV1806662001Medicaid